Belatedly, here is an account of the third NCT class, which was an all-day class on Saturday 13th October. I started writing this not long after the class and have been working on it on and off ever since, so my memories will probably get progressively less accurate as the post proceeds and heaven only knows how faint a resemblance they’ll bear to reality by the time I get to the end.
I arrived at the class to find several of the others already there. Some of them were standing in a little knot inside the cottage doorway, chatting away, but one man was having a conversation with Philippa from which lines like "They had to give her Pethidine at that point…" floated out to me. It sounded as though another member of the class had had her baby in the interim; and this was indeed the case.
As I’d guessed, it was Fiona. Her husband had come to fill Philippa in on the details before dashing back to mother and child, and Philippa relayed them to us before we started. Baby Henry had been born on October 11th, three days before his due date, with Fiona’s labour coinciding nicely with Alex’s planned admission to the hospital – Alex had ended up sitting with Fiona for several hours of her labour, talking her through the contractions.
After all that excitement, we settled down to the day’s warm-up exercise. Philippa asked us to tell the group somewhere where we were looking forward to taking the baby, but then remembered we’d done that one already and asked us instead to name the quality of our partner that we most hoped he/she would pass on to the baby. I had to think about this for a moment to decide which quality of Barry’s I’d put top of the list – I mean, obviously I want the baby to have his brains and his amazing capacity for picking up random bits of knowledge and his great quirky sense of humour and his ability to fix anything and his interest in my life and sympathy when I’ve had a bad day and his generosity, so the terms of the question required some prioritising to be done. Still, I didn’t find it too hard to pick out the one I’d put at the top of the list – my husband’s ability to think for himself. He never swallows the party line on anything. He will always pick up on some way of looking at things that I wouldn’t have thought of, and come out with some original and thought-provoking opinion, helped in doing so by his astonishing ability to notice the details other people’s brains don’t pick up (I realise that that’s a rather sneaky way of getting in two qualities at once, which is probably cheating, but what the heck). Remember when that Gina Ford programme was on and everyone had an opinion on whether or not that baby should have been left to cry but Barry was the only person I knew who picked up the subtle inconsistencies that meant that, in fact, that scene was probably edited to make it look as though the baby was crying when he actually wasn’t? Uh-huh. That’s Barry.
After this, we drew up a list of points we hoped to cover during the day, since this was going to be our last class with Philippa (we had one left, but it was the breastfeeding class, with a different teacher), and Philippa decided that we should start out by a quick discussion of the whole issue of problems with the baby. "I’m going to ask you to open up the door on that dark room in your mind where you hide the possibilities you don’t want to look at," she told us, and I braced myself to talk about stillbirths. As it happened, Philippa wasn’t planning to get nearly that dark. "Let’s suppose," she told us "that a couple have their baby and things don’t turn out quite as well as expected – it turns out there’s something wrong with the baby. Maybe just something minor – something that will need a minor operation, or a tongue tie." (Hello? Having had a baby with a tongue tie, I certainly don’t recall feeling any particular drama about being told.) "Or maybe it’s something worse. Like – say – Down’s Syndrome. How do you think that couple might feel?"
We had quite a good discussion about the kind of reactions people might have in this situation, and about the kind of reactions the other people in the group might have – Philippa told us about one couple from one of her groups who’d had a baby with Down’s syndrome and found that the other members of the group effectively shunned them through feeling too embarrassed and awkward to talk to them. The poor couple, who’d had a lovely home water birth, wanted to talk about what a great experience that had been and to show their baby off to the group, but they ended up being quite excluded. It was a useful talk, I felt. Then Philippa wound it up by assuring us that since we were now going to move onto other things, we could put those issues back in the dark room in our mind and close the door on them.
Um, yes. Because of course encouraging us to think about having a handicapped child as a prospect so awful it needs to be shut away in a dark room in our mind and not looked at is a constructive way of dealing with the possibility.
I don’t think of the possibility of a handicapped child as something that needs to be shut away in a dark room in my mind. I guess I think of it more as one of those untidy piles of paper that clutter up my study and make it unsightly – the ones that I’d rather not have around but nevertheless accept as part of my life’s landscape, and ultimately better dealt with than ignored. I don’t want a child with Down’s syndrome, but it isn’t something I see as such a terrible unthinkable possibility, and it’s pretty benign compared to some of the other stuff out there. (I remember looking out the links on anencephaly for the IDE post, back in the early months of my pregnancy before I’d had the scan – now that felt like visiting a dark place in my mind that I wanted to shut the door on.) Strewth. After that, I almost wanted to have a child with Down’s just so I could point out that it’s not actually the end of the world.
I can’t guarantee that the rest of this is a comprehensive list or in precise order, but here’s what I can remember of all the other things we did during the day, in something vaguely approximating the order in which we did them:
Walking Through The Jungle. This is a game that involves standing in a circle with your hands on the shoulders of the person in front of you. Each person in turn names an animal, and all participants imitate that animal’s movements with their hands on the shoulders of the person in front of them. This was, apparently, something to do with getting us thinking about the kinds of touches that might be good in caring for a newborn baby (in case, say, we had been having difficulty working out for ourselves whether clawing like a lion or stomping like an elephant might be appropriate ways of taking care of a newborn and needed the examples to help us decide). This was quite soon after the above discussion about possible problems with the baby, though not immediately after – from some comment Philippa made, I got the impression that the idea was to get our minds well and truly off The Awful Possibility Of Down’s Syndrome, just in case anyone was still suffering ongoing trauma from the thought. What it actually did was to give me the rather surreal feeling of having been mistaken for a member of my son’s Tumbletots’ class.
Recovery in the aftermath of Caesareans. This was aimed mainly at James, Alex’s husband, who seemed quite taken aback by the news that his wife was going to spend several weeks recovering from surgery this major and that a considerable amount of help and input might be needed from him. "So how long will I be expected to be involved for?" he asked. I broke it to him that eighteen years is the usual amount of time where having a baby is concerned.
Life as a new parent – what a particularly bad day might be like. The class split up by gender for this one, with the men and the women being given a separate written account of this hypothetical day. The men were presented with a scenario where, having been woken up three times in the night by the baby crying and ending up unsuccessfully trying to sleep on the sofa, they then had the day from hell at work, rushing around to meetings with people being awkward, and having no chance to buy a sandwich for lunch to substitute for the cheese salad they had nobly left in the fridge for their partner (I’m kind of getting mixed up on the singular and plural pronouns here). The scenario ended up with the harassed father arriving home, exhausted and hungry, to find the house a complete tip and his wife sitting in front of the TV with her feet up and a glass of wine in her hand. You can see how this might lead to a certain amount of marital disharmony. You can also see that, no matter what your first reaction, it’s a good idea to hold off for long enough for a sympathetic "So how was your day, darling?", because the mother in this little story, meanwhile, had been having an equally awful day carrying around a baby who cried whenever he was put down and who had given her no chance to have a shower or a hot drink or eat the cheese salad that had been left for her or get on with any of the housework, until he finally fell asleep five minutes before Dad walked in the door. I do always try to remember to ask Barry about his day and be ready to sympathise before assuming that mine’s been harder, but this was a salutary lesson in he-said-she-said – I’ll have to remember to try really hard to do this when I’m back at work and he’s got two little ones to cope with at home.
Post-natal depression. We were given a series of cards with symptoms on them and had to sort them into categories according to whether they represented normal life with a baby or symptoms of post-natal depression – one lesson, of course, being that there’s a whole lot of overlap. We talked about how to recognise when normal hormonal swings and exhaustion were becoming something more serious, and what to do about it.
Settling babies. In an attempt to minimise the chances of the kind of day described in the last-but-one paragraph occurring, we made out a list of ways of settling a crying baby, from A to Z (getting them to correspond to each letter was not actually compulsory, but I think we did fairly well on that score as well).
Life with a new baby – the experiences of one NCT class Philippa had had in the past, who’d been asked, a few months down the line, to write down how they felt the first week with the baby had gone. It was quite encouraging, really, since most of them seemed to have coped pretty well. Oh, and apparently changing stations are the order of the day and it’s a good idea to buy two of them so that you can have one downstairs as well as one upstairs. (To give the other side of that – I never bought even one changing table, and would have found it a colossal waste of money and space if I had. When I’ve changed a pooey nappy I like to wash my hands before picking the baby up again, and you certainly can’t do that when they’re on a platform three feet off the ground, apart from in the extremely early stages. And I’m at a loss as to where we could have put it when we lived in the rented house we were in just before this one, which wasn’t very large. Talking of which, I’m also still trying to work out where all these people would have put their second changing station. It’s not the kind of thing you can fit into the average downstairs toilet or hall, so presumably there were a lot of changing tables in the living rooms or eating areas. Isn’t that – um – sort of unhygienic and unattractive? Would seem so to me, anyway.)
Caesareans. Philippa set up a little scenario to give us a feel of what a Caesarean would be like, with a patient (James) who lay on the floor, decorated with accoutrements designed to represent a drip and catheter, and a cast of thousands surrounding him, with little cards to tell everyone their role (obstetrician, obstetrician’s assistant, midwife, anaesthetist, paediatrician, health care assistant, Uncle Tom Cobley…) It was something of an eye opener for me. I’ve been to more Caesareans than I could begin to count (six months in obstetrics and twelve months in paediatrics adds up to a lot), but I never really thought about how many people were in the operating theatre on an average day. Operating theatres are generally big enough that they don’t feel crowded even with all those people there – at least, not when you’re one of the people and you’re standing up and there in your professional capacity with a job to do. But when you’re the one lying on the trolley, feeling vulnerable, and not knowing a lot about what’s happening or who in hell all those people are or why they’re there, I’m betting it feels quite different; and it’s something patients don’t really get any preparation for. Not from us as medics, anyway.
"Have you thought about how you’d like to find out the sex of the baby?" Philippa asked James. "Do you want to wait and find out for yourself rather than have anyone else tell you? I think that would be really nice, don’t you?" Given that the most relevant point here was whether James and Alex thought it would be really nice, I felt that last sentence might be a marginally pushy way of putting it. Then again, since I would personally hate it if a roomful of people who could see perfectly well what sex my baby was were keeping me waiting for the information under the mistaken impression that this state of suspense and being the last to know was somehow ‘really nice’ for me, perhaps I’m a bit biased. I decided that making a fuss about that point would be a bit excessive and perhaps I should try the novel experience of keeping my mouth shut, but then Philippa went on to suggest that James and Alex could also request that their voices be the first ones the baby heard after its birth, and I felt that was unrealistic enough as a part of a Caesarean birthing plan that I had to say something. I mean, a person performing surgery needs to address a few words to the people assisting from time to time. While it would be feasible in all cases except rare emergencies for an obstetrician to keep quiet for long enough after the baby emerged to allow one or other parent to say "Hello, little one, welcome to the world," or whatever it is they want the words first heard by the baby after birth to be, how exactly would you synchronise it? Caesareans take place behind a screen. It’s a rare man who wants to look over to see what’s going on, and something told me James wouldn’t be that exception. (Which goes to show you how wrong I can be, since I’ve since seen Alex who tells me that’s exactly what he did, although they did not bother to use the information for purposes of making their voices heard first.) Is the obstetrician supposed to sign to the parents that the baby is now emerging and they’d better speak now if they want their voices to be the First Heard? Or what? It all struck me as a bit too impractical. I tried to say this and Philippa and I had a brief but impassioned exchange of views which was cut short by Sean, as the obstetrician in the vignette, declaring that he wasn’t having this sort of dissent in his operating theatre, thank you. I was quite impressed at the job he was doing of getting into character.
Nappy changing (without benefit of changing stations, duplicate or single). Philippa had a bunch of dolls rigged up with nappies and various food items designed to simulate the real-life experience of changing a newborn’s nappy, so that we could practice. Don’t know how helpful anyone found this – nappy changing was not a prospect that particularly fazed me when I
was first anticipating motherhood (probably about the only thing that
didn’t), but then, my paeds SHO job had given me the occasional
opportunity to practice for real, which I suppose is not an experience
everyone has had these days, and it probably is good to feel like you’ve changed at least one nappy in rehearsal before facing the real thing. This time around, of course, my main thought was that changing nappies on a doll was quite a lot easier than changing nappies on a toddler. After years of changing Jamie, I tend to forget that in the early days babies actually do lie still. In fact, changing the doll was probably harder than changing a newborn – newborns bend in the middle and thus you do not find yourself suddenly balancing the baby on its head when all you were trying to do was to lift up its legs high enough to get the nappy off, and newborns also don’t have gaps in their hip joints for gunk to work its way into and need cleaning out of.
Assisted delivery. This means Ventouse deliveries (suction cup on the baby’s head to help get it out, used when a woman has got well into second stage but things have stalled and/or the baby is becoming distressed) and forceps deliveries (metal thingies slid round the sides of the baby’s head to pull it out, used in similar circumstances but with a bit more oomph for getting babies out, though with added risks along with that). I can’t think of anything much to say about this bit – we just went briefly through what each meant and what was involved.
Pain relief. This is where the NCT seems to get a lousy press, with people queuing up to tell their stories of how their eeeeeevil NCT teacher presented pain relief as being for wimps or, worse, Bad Mothers, and made it clear that natural childbirth was The One True Way To Go. Nothing of the sort happened in this class. Having dissed what Philippa was saying on so many other subjects during this post, I do gain pleasure from ending on a positive note here. She briefly reiterated ways we’d already discussed of relieving pain without using medication and thus minimising the need for medication, talked about what was available medication-wise, and told us about the possible side-effects and disadvantages while also giving us examples of situations where pain relief might be useful. No moralising, no telling us what we should do, just some decent balanced information to let us make our own minds up.
And that’s about it for the day. The one other thing I would add, since this session was the last we had at Philippa’s cottage and thus I will not get another opportunity to mention it, is a mention of the Cat Who Collects Banana Skins. I do not (fortunately) have an anecdote within which to present this bald statement – Philippa owns a cat who collects banana skins and leaves them lying around on footpaths, that’s all. However, the idea of a teacher of antenatal classes owning such a cat is one so rich with horrendous slapstick possibilities that I felt I couldn’t let it pass unremarked.